HomeMy WebLinkAboutFMC Application 6-21-21UNDERGROUND STORAGE TANKS
APPLICATION
TO PERFORM ELD/LINE TESTING/
SB989 SECONDARY CONTAINMENT
TESTING/TANK TIGHTNESS TESL` AND
FUEL MONITORING CERTIFICATION
(Please note that these are separate
individual tests and Will be Charged per
separate type test accordingly.)
PERMIT #
❑ ENHANCED LEAK DETECTION
❑ TANK TIGHTNESS
❑ LINE TESTING
FMI FUEL MONITORING CERTIFICATION
SITE INFORMATION
BAKERSFIELD FIRE DEPARTMENT
Prevention Services
2101 H Street
Bakersfield, CA 93301
Phone: 661-326-3979 9 Fax: 661-852-2171
Page 1 of 1
❑ SB -989 SECONDARY CONTAINMENT
❑ OVERFILL PREVENTION
FACILITY NAME & PHONE # OF CONTACT PERSON
METRO MART- VALERO GEORGE FARAH 661 900-8788
ADDRESS
14600 STINE ROAD Bakersfield, CA 93313
OWNER NAME
EL MANAHRI INC
OPERATOR NAME PERMIT TO OPERATE #
GEORGE FARAH
# OF TANKS TO BE TESTED: IS PIPING GOING TO BE TESTED? L
d
S
YES 13NO
T A N K #
VOLUME
CONTENTS
12,000
87
2
127000
87
3
127000
7
91
Y
4
12,000
Diesel
d
3
S
k
C
p3
TANK TESTING COMPANY
Y
TESTING COMPANY
Advanced Compliance
NAME & PHONE # OF CONTACT PERSON
Leann Hamilton 661-808-5323
MAILING ADDRESS
4007 Brae Burn Dr Bakersfield Ca
f
y
NAME & PHONE # OF TESTER OR SPECIAL INSPECTOR
Bruce Hinsley
CERTIFICATION #
A25212
TEST METHOD
PEI RP1200-17
ICC #
8032698
APPLICANT SIGNATURE
A
Wm;
DATE
�—
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
APPROVED BY
DATE
FD2095 (Rev 09/20)